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Home My WebLink About1000-63.2-1-15 T OWN OF SOUTHOLD _ s Rental Permit Permit No. 0089 Owner Ann Ristuccia Occupied as Single Family Dwelling Located at 2555 Youngs Ave,Unit 7E Southold 63.2-1-15 Address Village S/B/L Maximum Permitted Occupancy 4 Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 6/19/2019 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times r Town Hall Annex ` Telephone(631)765-1802 54375 Main Roads C Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 I� � X" rye,. BUILDING DEPARTMENT TOAVN OF SOUTHOLD RENTAL PERMIT APPLICATION Rental Permit Fee$200(Application must be renewed every two years) Section A. Property Information: Rental Property Address: PC Tax Map Number: 1000 SECTION �3- 0, --BLOCK, -LOT /S - SECTION . OWNER INFORMATION: Property Owner Name: A/A/ S Property Owner Legal Address: Property Owner Mailin Address: i -7� Telephone Number(s): Daytime ' Emergency 6� 7 h '6 7 Property Owner Email Address: F' r S tL4 CC I Q (6) C UVB L-1 ) Lj Page 1 of 5 Town Hall Annex �� io Telephone(631)765-1802 54375 Main Road �n r Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLID Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: ----A'//�- Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: AV 4 Address of Managing Agent (no P.O. Boxes): Page 2 of 5 Town Hall Annex % Telephone(631)765-1802 54375 Main Road k Fax 631 765-9502 P.O.Box 1 179 ' Southold,NY 1 1 971-0959 ` BUILDING DEPARTMENT TOWN OF SOU OLD Mailing Address of Managing Agent: " /1- Telephone Number(s): Daytime Evening_ Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: f- €ti7`/�L �� oc/tn �r° %Ui`�P��lS Vl 1 *67� yr✓r S ,t �/�3�l2 U j' Uiv) T5 T%,J 4,47 Number of Rental Dwelling Units on property: For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, C);the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: C//V/ Requested Maximum number of Persons allowed to occupy Dwelling Uni z Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: L 6 �,(r x,, f _ - Page 3 of 5 d„ Town Hall Annex �' Telephone(631)765-1802 54375 Main Road �F ' w� Fax(631)765-9502 i P.O.Box 1 179 ` C1111, Vow j Southold,NY 11971-0959 ton BUILDING DEPARTMENT TOWN OF SO O SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer or a home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification is required stating that the property which is the subject of the rental permit application is in compliance with all of the provisions of the code of the Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold 11 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) 1 4NN Fi S 7-U cCr/ , certify under penalty of perjury,the following: 1. 1 am the owner of the property identified in "Section A" of this application. 2. The property owner's legal address set forth in "Section B" of this application is my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 ' Town Hail Annex Telephone(631)765-1802 ], 1�, 54375 Main Roadr � ,d Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 " g�oel, wv r BUILDING DEPARTMENT applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent,-Managing Agent, or Site Manager. Property Owner's Name: c Property Owner's Signature: Sworn to before me this day of -T 14 20L/� Official N tary Pi iic Signature and Original Notary Stamp MARGARET C RUTKOWSKI NOTARY PUBLIC,STATE OF NEW YORK Registration No.01RU4982528 Qualffied in Sullolka ty oZ� MY Page 5 of 5 Friday, June 7, 2019 Ann Ristuccia 631 765 1111 . 631 379 6687 Re: 2555 Youngs Ave Southold NY 11971 (Founder's Village) Please be advised you must call the tenants for access to rental unit 7E. Elisabeth or Walter Olsen. 631 361 6515 Thank you TOWN OF SOUTHOLD BUILDING DEPT. 7651802 JON' INSPECT i f [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING e&#vj# [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION ( ] CAULKING i DATE INSPECTOR i l Z LP G C — Z r kp C / 77 2�j � o A l . G LQJ ET # " Cl ad a s s o IL-M9 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17450 Date OCTOBER 24 1988 THIS CERTIFIES that the building MULTIPLE DWELLING Location of Property 2555 YOUNGS AVENUE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 63.2 Block 001 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1 1987 ______pursuant to which Building Permit No. .15839Z dated APRIL 2 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is BUILDING #7 - UNIT E IN MULTIPLE DWELLING. The certificate is issued to LIZDA REALTY LTD - FOUNDERS VILLAGE (owner, XXXXXXXM. XXX M) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 5-54 OCT. 21 1988 UNDERWRITERS CERTIFICATE NO. PENDING 10/12/88 PLUMBERS CERTIFICATION DATED MICHAEL DUFF INC. 10 3 88 Building Inspector Rev. 1/81